For healthy patients a better mouthfeel of a foodstuff can be a reason to eat it more often simply because they prefer the “taste” of it. For dysphagia patients things are however completely different. In fact a good mouthfeel may be considered a matter of life and death. Dysphagia patients are afraid to consume foodstuffs that appear too thin to them, because they fear to choke. This fear often shows by a reluctance to eat or drink and may lead to dehydration and mal-nutrition.
People with dysphagia generally lack proper muscle control and coordination to properly seal the windpipe or they lack the ability to properly propel the entire bolus of food and/or beverage to the stomach. For these reasons it is extremely important that the foodstuffs dysphagia patients consume have the proper viscosity when they judge the food visually and when they feel it in their mouth during consumption.
Thickening the beverages for humans afflicted with dysphagia is a common method of managing dysphagia. Thickening provides better bolus control, greater oral stimulation, and when swallowed, if incompletely propelled into the esophagus, it helps prevent undesired and potentially fatal aspiration of fluids into the lungs. Generally and most commonly, starch is used to thicken beverages of dysphagia patients. Starch is also the preferred ingredient in view of its properties, cost price, taste and thus acceptance by dysphagia patients.
For dysphagia patients several products are avail able for thickening liquids and foods. Such a thickening product is known from WO2004/069179 where non-starch polysaccharides are used in thickened beverage compositions for the treatment of dysphagia patients. WO01/1789 relates to a gelled nutritional composition including gelled whey protein suitable for dysphagia patients. WO03/055334 describes a method for preparing thickened foods suitable for dysphagia patients wherein said binding, gelling or thickening compound is selected from the group consisting of proteins, carrageenans, starches, gums, gelatins, or a combination thereof. WO03/011051 describes a concentrate thickener paste and the use thereof for thickening liquid food suitable for patients with dysphagia. The concentrate thickener is selected from at least one of alginates, carrageenan, galactomannans, cellulosics, food starches, xanthan gum and gum Arabic.
The disadvantage of the products presented in the prior art is that they do not combine all the necessary properties needed for treatment of dysphagia patients. WO2004/069179 and WO01/01789 describe the use of pre-thickened beverages or foods. These types of products are suitable for treating dysphagia patients but have the disadvantage of being unable to thicken other liquids or foods as is often not only required but also preferred by patients. In the method of WO03/055334 and in document WO03/011051 this problem is solved by using a thickener suitable for thickening any food. However WO03/055334 and WO03/011051 only describe a method for preparing thickened food but do not solve the important problem that the product is not stable during consumption due to the activity of amylase from saliva. The invention of WO03/055334 is not related to the problem of preparing a thickener composition. WO03/011051 relates to a concentrate thickener paste for thickening liquids and indicates in the text that the use of powders as thickening agents is disadvantageous due to clumping caused by bad hydration properties. Due to the water retaining properties of xanthan gum in the colon, the preferred embodiment of WO03/055334 where xanthan gum is used as a thickening agent, has the disadvantage of retaining water in the gut. It is known that dysphagia patients often suffer from dehydration. The use of xanthan gum is therefore a disadvantage and the xanthan gum content in the thickened products should preferably be as low as possible.